Provider Demographics
NPI:1093739765
Name:SUDDHA PHARMACY, LLC
Entity Type:Organization
Organization Name:SUDDHA PHARMACY, LLC
Other - Org Name:FEDCO DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DIPTI
Authorized Official - Middle Name:V
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:561-659-6713
Mailing Address - Street 1:255 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33480-3876
Mailing Address - Country:US
Mailing Address - Phone:561-833-3348
Mailing Address - Fax:561-832-7783
Practice Address - Street 1:255 SUNRISE AVE
Practice Address - Street 2:
Practice Address - City:PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33480-3876
Practice Address - Country:US
Practice Address - Phone:561-833-3348
Practice Address - Fax:561-832-7783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS39255183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty